Domestic Insurers are required to file the following documents by applicable dates:
- Annual Financial Statement - March 1
- Annual Audit and Examination Fee - March 1
- Annual Fraud Unit Assessment Fee - June 1
- 3 Quarterly Financial Statements - May 15, August 15, and November 15
- Management Discussion and Analysis - April 1
- Audited Financial Statements (CPA Report) - June 1
- Form A – click HERE to electronically submit PDF copy of Form A and payment of $2,500 fee.
- Form A Amendment – click HERE to electronically submit PDF copy of Amendment to Form A and payment of $1,250 fee.
- Form A Exemption – click HERE to electronically submit PDF copy of an Application for Exemption from Form A and payment of $1,250 fee.
- Disclaimer of Affiliation – click HERE to electronically submit PDF copy of a Disclaimer of Affiliation and payment of $1,250 fee.
- Form B (including a $650 fee) - June 1
- Form B Exemption (including a $200 fee) - June 1
- Form C (including a $650 fee) - June 1
- Form D (including a $650 fee)
- Form E (including a $250 fee)
- Form E Exemption (including a $100 fee)
- Form F (including a $250 fee)
- Solicitation Permit – click HERE to electronically submit PDF copy of Application for Soliciation Permit and payment of $250 fee.
Premium Tax and Fee Filings
Service Contract Provider Forms
All Sections listed on the following pages have instructions. Please download
these instructions along with the required form.
- As standard printed forms, these would be "front and back".
- As PDF Downloads - please make sure you print all of the pages of the form.
Vehicle Protection Product Warrantors Forms
- Forms
- As PDF Downloads - please make sure you print all of the pages of the form.